Impacted Children and Siblings

The Impacted Child

The Impacted Child

It is critical to prioritize the well-being of children who have been directly impacted by other children’s problematic sexual behavior as well as siblings. Children who have experienced problematic sexual behavior from another youth can exhibit a wide range of outcomes. Further, siblings who may not have been directly involved in the problematic sexual behavior can be affected by the events and responses. It is important to make sure all children have the support they need as they grow. An initial assessment with a licensed mental health provider can help determine well-being and treatment needs.

It is important that caregivers look for a pattern of changes in their child’s behavior or emotions. Have they suddenly become withdrawn or really irritable with friends and family? Do they seem a lot more nervous or jumpy? Are they having nightmares or suddenly intrusive memories about scary things that have happened? Have they started wetting the bed again after growing out of those issues?

Some children may exhibit trauma-related symptoms after experiencing problematic sexual behavior from another child. These symptoms include things like nightmares, re-enacting the behaviors in play or drawings, avoiding specific people or places that remind them of what happened, negative feelings about themselves or the world, increased jumpiness, difficulties concentrating, or irritability. If your child who was impacted is showing symptoms that are consistent with posttraumatic stress, it is important to have them assessed by a licensed mental health professional. For some children, the impact of sexual behavior by another child might manifest differently, such as acting out at home or at school, refusing to listen, or having big tantrums or outbursts. Children with these kinds of behaviors that began after being impacted by sexual behavior from another child are likely to benefit from a trauma-informed behavioral treatment from a mental health professional.

Other children may show a mix of other mental health symptoms, like anxiety or depression. They may withdraw from friends and families or from activities that they really used to enjoy.

Some children don’t really have any negative reactions from the experience of sexual behavior by another child. They may not have perceived the experience as negative. An immediate response of belief and support may have minimized the impact. For these children, teaching them simple rules around healthy boundaries with other children and ensuring they know some basic abuse prevention skills may be enough. However, it is important to continue to check in with your child, monitor for the development of other symptoms or behavioral changes, and seek help anytime you feel it necessary to do so.

How Does Sexual Behavior Impact Children?

Children who experience sexual behaviors initiated by another child can have a wide range of responses. Some children function have no trauma symptoms, nor any other significant behavioral or emotional concerns. Other times children might experience responses that can include:

  • Re-enacting the experience with peers, dolls or stuffed animals
  • Demonstrating sexual knowledge and sexual behaviors that are not typical for the age of the child
  • Anxiety (such as difficulty separating from parents)
  • Anger, aggression, argumentativeness, and defiance
  • Symptoms of prolonged sadness, depression, or abrupt mood changes 
  • Confusion about relationships with peers
  • Difficulty making and keeping friends 
  • Nightmares and fears
  • Startling easily to loud noises or sudden movements
  • Avoiding anything that reminds them of the event

What Factors Influence how the Impacted Children Responds?

Factors that influence a child’s response to experiencing sexual behavior problems include:

The response and support by the parents and other caregivers following the incident(s) The length of time in which the sexual behaviors take place (sexual behaviors that occur over a longer period of time are more harmful) How many times the problematic sexual behavior happened (sexual behaviors that happen on multiple occasions) The type and closeness of the relationship among the children (such as, whether they were siblings, close friends, acquaintances, or strangers) How scary the situation was for the child. Fear and worry may be related to age/size difference of the children, and the use of threats, coercion, aggression, or force The type of sexual behavior, such as whether genital contact and penetration was involved The child’s recent functioning (for example, children who were already struggling with depression, anxiety, or other concerns will have a more negative impact to the problematic sexual behavior than children who were happy, had friends, and were otherwise doing well) The response and supports by the professionals who may become involved after the incident is discovered. Professionals may be from child protective services, law enforcement, school personnel, and behavioral health specialists. (Whether or not the assessment, investigation, safety planning, and treatment was provided in a child friendly, calm, and supportive manner can impact child response).

How Do I Know How Best To Support My Child?

Research indicates that parental responses play a key role in a child’s response to experiencing problematic sexual behavior initiated by another youth. Specifically, remaining calm, and nurturing makes a difference for the children. Clearly communicating the belief in the disclosure along with developing and implementing a safety plan are key elements in a response that will be supportive to your child. Children who show symptoms of distress can be evaluated by a licensed behavioral health specialist (such as a psychologist, social worker, psychiatrist, or licensed professional counselor) with experience in child trauma to determine what supports and help would be best.

What Type of Treatment May be Helpful? ?

Short-term community-based treatment may be recommended to provide therapy and support to the child and caregivers. If the child is demonstrating trauma symptoms, Trauma-Focused Cognitive- Behavioral Therapy (TF-CBT) may be recommended. TF-CBT is a type of therapy for children who experienced a traumatic event, including problematic sexual behavior from other children. TF- CBT has been identified by multiple federal and state agencies as a “best/model practice” and is considered to be the gold standard treatment for these children. TF-CBT is an out-patient therapy for the child and their caregiver(s) that is typically completed in 12-24 sessions. Some of the things covered in sessions includes teaching children skills for relaxation, emotional expression, coping, problem-solving, and safety planning. In addition, directly addressing the trauma gradually is utilized to reduce anxiety and distress related to trauma memories. Caregivers learn methods for assisting their children with healthy coping and techniques for managing challenging child behaviors. Caregivers also participate in the sessions where the trauma is addressed to learn ways to communicate with their child about the traumatic experience and to enhance the parent-child relationship.

Children respond best when their caregiver is calm, supportive, caring, and resourceful. It is important to note that caregivers have a range of responses themselves and may struggle with remaining calm - see Taking Care of You for ways to find support.

If you notice a significant change in your child’s emotions or behaviors after they experienced problematic sexual behavior from another child, we recommend that you reach out to a mental health provider in your area for assessment and support. Specifically, agencies where therapists are trained in Trauma-Focused Cognitive Behavioral Therapy are a good starting point when searching for a provider for an assessment. A list of Nationally Certified TF-CBT therapists can be found here

Learn more about treatment for impacted children through this webinar by expert Dr. Esther Deblinger

The family situation is more complicated when siblings are involved in the problematic sexual behavior. In some circumstances, in order to have immediate safety, changes in the family living situation may be needed. See Safety Planning sections for more details. Always consider the victim and/or impacted child’s possible wishes, well-being and responses when making decisions. Avoid any pressure to live with or be reunified with children who have caused harm. Having all family members involved in evidence based treatments can bring healing and hope.

Find information about evidence-based treatments through the California Evidence-Based Clearinghouse and OJJDP’s Evidence Based Program directory. Here is an example:

Trauma-Focused Cognitive Behavior Therapy is an effective treatment for children impacted by traumatic experiences.